Yıl: 2020 Cilt: 31 Sayı: 2 Sayfa Aralığı: 260 - 266 Metin Dili: İngilizce DOI: 10.5606/ehc.2020.72592 İndeks Tarihi: 04-05-2021

Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats

Öz:
Objectives: This study aims to investigate the effects of hyperbaric oxygen (HBO) therapy and platelet-rich plasma (PRP) on the regeneration of osteochondral defects of the rats, and the synergistic effect of this combined treatment.Materialsandmethods:This randomized, controlled, and interventional animal study was conducted between May 2014 and August 2014 Osteochondral regeneration was evaluated in four treatment groups (control, PRP, HBO, and HBO+PRP groups) at the 30th day after iatrogenic injury. Thirty-two female Wistar albino rats (weighing 248-305 g) underwent arthrotomy and osteochondral surgery on left knees. The regenerations of defects were then examined histologically by the modified version of O’Driscoll score.Results: Groups that were treated with either HBO or PRP alone regenerated significantly better than the control group (p=0.01), while no significant difference was found between the HBO- and PRP-treated groups (p>0.05). The defects in group 4 (treated with both HBO and PRP) regenerated significantly better than the control group, the HBO-treated group alone, and the PRP-treated group alone (p=0.01).Conclusion: The results of this study showed a synergistic effect of HBO and PRP on knee cartilage regeneration. However, the possible underlying mechanisms should be the subject of future researches. The aggregation and activation of growth factors released from platelets whose activation is increased in the hyperbaric environment may explain this effect. This may result in a better regeneration than the effect of PRP or HBO alone.
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  • 1. Alford JW, Cole BJ. Cartilage restoration, part 1: basic science, historical perspective, patient evaluation, and treatment options. Am J Sports Med 2005;33:295-306.
  • 2. Burks RT, Greis PE, Arnoczky SP, Scher C. The use of a single osteochondral autograft plug in the treatment of a large osteochondral lesion in the femoral condyle: an experimental study in sheep. Am J Sports Med 2006;34:247-55.
  • 3. Sezgin EA, Atik OŞ. Are orthobiologics the next chapter in clinical orthopedics? A literature review. Eklem Hastalik Cerrahisi 2018;29:110-6.
  • 4. Sams AE, Nixon AJ. Chondrocyte-laden collagen scaffolds for resurfacing extensive articular cartilage defects. Osteoarthritis Cartilage 1995;3:47-59.
  • 5. Newman AP. Articular cartilage repair. Am J Sports Med 1998;26:309-24.
  • 6. Laskin RS. The classic: total condylar knee replacement in patients who have rheumatoid arthritis. A ten-year follow-up study. 1990. Clin Orthop Relat Res 2008;466:2589-96.
  • 7. Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop 2008;79:499-507.
  • 8. Krüger JP, Hondke S, Endres M, Pruss A, Siclari A, Kaps C. Human platelet-rich plasma stimulates migration and chondrogenic differentiation of human subchondral progenitor cells. J Orthop Res 2012;30:845-52.
  • 9. Nishimori M, Deie M, Kanaya A, Exham H, Adachi N, Ochi M. Repair of chronic osteochondral defects in the rat. A bone marrow-stimulating procedure enhanced by cultured allogenic bone marrow mesenchymal stromal cells. J Bone Joint Surg Br 2006;88:1236-44.
  • 10. Sun Y, Feng Y, Zhang CQ, Chen SB, Cheng XG. The regenerative effect of platelet-rich plasma on healing in large osteochondral defects. Int Orthop 2010;34:589-97.
  • 11. Kon E, Filardo G, Delcogliano M, Fini M, Salamanna F, Giavaresi G, et al. Platelet autologous growth factors decrease the osteochondral regeneration capability of a collagen-hydroxyapatite scaffold in a sheep model. BMC Musculoskelet Disord 2010;11:220.
  • 12. Milano G, Deriu L, Sanna Passino E, Masala G, Manunta A, Postacchini R, et al. Repeated platelet concentrate injections enhance reparative response of microfractures in the treatment of chondral defects of the knee: an experimental study in an animal model. Arthroscopy 2012;28:688-701.
  • 13. Milano G, Deriu L, Sanna Passino E, Masala G, Saccomanno MF, Postacchini R, et al. The effect of autologous conditioned plasma on the treatment of focal chondral defects of the knee. An experimental study. Int J Immunopathol Pharmacol 2011;24:117-24.
  • 14. Qi YY, Chen X, Jiang YZ, Cai HX, Wang LL, Song XH, et al. Local delivery of autologous platelet in collagen matrix simulated in situ articular cartilage repair. Cell Transplant 2009;18:1161-9.
  • 15. Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Timoncini A, et al. Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. Arthroscopy 2011;27:1490-501.
  • 16. Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, et al. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 2010;18:472-9.
  • 17. Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML, Cenacchi A, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord 2012;13:229.
  • 18. Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med 2013;41:356-64.
  • 19. Lee GW, Son JH, Kim JD, Jung GH. Is platelet-rich plasma able to enhance the results of arthroscopic microfracture in early osteoarthritis and cartilage lesion over 40 years of age? Eur J Orthop Surg Traumatol 2013;23:581-7.
  • 20. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006;2:CD005321.
  • 21. Wang CT, Lin J, Chang CJ, Lin YT, Hou SM. Therapeutic effects of hyaluronic acid on osteoarthritis of the knee. A meta-analysis of randomized controlled trials. J Bone Joint Surg [Am] 2004;86:538-45.
  • 22. Chen AC, Lee MS, Lin SS, Pan LC, Ueng SW. Augmentation of osteochondral repair with hyperbaric oxygenation: a rabbit study. J Orthop Surg Res 2010;5:91.
  • 23. Sundman EA, Cole BJ, Karas V, Della Valle C, Tetreault MW, Mohammed HO, et al. The anti-inflammatory and matrix restorative mechanisms of platelet-rich plasma in osteoarthritis. Am J Sports Med 2014;42:35-41.
  • 24. Spreafico A, Chellini F, Frediani B, Bernardini G, Niccolini S, Serchi T, et al. Biochemical investigation of the effects of human platelet releasates on human articular chondrocytes. J Cell Biochem 2009;108:1153-65.
  • 25. Park KH, Na K. Effect of growth factors on chondrogenic differentiation of rabbit mesenchymal cells embedded in injectable hydrogels. J Biosci Bioeng 2008;106:74-9.
  • 26. Solorio LD, Dhami CD, Dang PN, Vieregge EL, Alsberg E. Spatiotemporal regulation of chondrogenic differentiation with controlled delivery of transforming growth factor-β1 from gelatin microspheres in mesenchymal stem cell aggregates. Version 2. Stem Cells Transl Med 2012;1:632-9.
  • 27. Boswell SG, Cole BJ, Sundman EA, Karas V, Fortier LA. Platelet-rich plasma: a milieu of bioactive factors. Arthroscopy 2012;28:429-39.
  • 28. Sahni T, Hukku S, Jain M, Prasad A, Prasad R, Singh K. Recent Advances in Hyperbaric Oxygen Therapy. Medicine Update 2014;14: 632-9.
  • 29. Chander Y, Misra RN, Rai R. Hyperbaric oxygen therapy [HBOT]. Med J Armed Forces India 1999;55:89-90.
  • 30. Strauss MB. Role of hyperbaric oxygen therapy in acute ischemic and crush injuries. An orthopedic perspective. Hyperbaric Oxygen Rev 1981;2:87-106.
  • 31. Aguiar P, Amaral C, Rodrigues A, de Souza AH. A diabetic foot ulcer treated with hydrogel and hyperbaric oxygen therapy: a case study. J Wound Care 2017;26:692-5.
  • 32. Atik OŞ. Is there something new and interesting in my article? Eklem Hastalik Cerrahisi 2019;30:69.
  • 33. O’Driscoll SW, Keeley FW, Salter RB. The chondrogenic potential of free autogenous periosteal grafts for biological resurfacing of major full-thickness defects in joint surfaces under the influence of continuous passive motion. An experimental investigation in the rabbit. J Bone Joint Surg [Am] 1986;68:1017-35.
  • 34. Shaw FL, Winyard PG, Smerdon GR, Bryson PJ, Moody AJ, Eggleton P. Hyperbaric oxygen treatment induces platelet aggregation and protein release, without altering expression of activation molecules. Clin Biochem 2009;42:467-76.
  • 35. Neves PC, Abib Sde C, Neves RF, Pircchio O, Saad KR, Saad PF, et al. Effect of hyperbaric oxygen therapy combined with autologous platelet concentrate applied in rabbit fibula fraction healing. Clinics (Sao Paulo) 2013;68:1239-46.
  • 36. Schneppendahl J, Jungbluth P, Sager M, Benga L, Herten M, Scholz A, et al. Synergistic effects of HBO and PRP improve bone regeneration with autologous bone grafting. Injury 2016;47:2718-25.
APA KORUCU İ, Kekeç A, ARSLAN A, oltulu p, özer m (2020). Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. , 260 - 266. 10.5606/ehc.2020.72592
Chicago KORUCU İsmail Hakkı,Kekeç Ahmet Fevzi,ARSLAN ABDULLAH,oltulu pembe,özer mustafa Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. (2020): 260 - 266. 10.5606/ehc.2020.72592
MLA KORUCU İsmail Hakkı,Kekeç Ahmet Fevzi,ARSLAN ABDULLAH,oltulu pembe,özer mustafa Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. , 2020, ss.260 - 266. 10.5606/ehc.2020.72592
AMA KORUCU İ,Kekeç A,ARSLAN A,oltulu p,özer m Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. . 2020; 260 - 266. 10.5606/ehc.2020.72592
Vancouver KORUCU İ,Kekeç A,ARSLAN A,oltulu p,özer m Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. . 2020; 260 - 266. 10.5606/ehc.2020.72592
IEEE KORUCU İ,Kekeç A,ARSLAN A,oltulu p,özer m "Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats." , ss.260 - 266, 2020. 10.5606/ehc.2020.72592
ISNAD KORUCU, İsmail Hakkı vd. "Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats". (2020), 260-266. https://doi.org/10.5606/ehc.2020.72592
APA KORUCU İ, Kekeç A, ARSLAN A, oltulu p, özer m (2020). Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. Joint diseases and related surgery, 31(2), 260 - 266. 10.5606/ehc.2020.72592
Chicago KORUCU İsmail Hakkı,Kekeç Ahmet Fevzi,ARSLAN ABDULLAH,oltulu pembe,özer mustafa Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. Joint diseases and related surgery 31, no.2 (2020): 260 - 266. 10.5606/ehc.2020.72592
MLA KORUCU İsmail Hakkı,Kekeç Ahmet Fevzi,ARSLAN ABDULLAH,oltulu pembe,özer mustafa Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. Joint diseases and related surgery, vol.31, no.2, 2020, ss.260 - 266. 10.5606/ehc.2020.72592
AMA KORUCU İ,Kekeç A,ARSLAN A,oltulu p,özer m Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. Joint diseases and related surgery. 2020; 31(2): 260 - 266. 10.5606/ehc.2020.72592
Vancouver KORUCU İ,Kekeç A,ARSLAN A,oltulu p,özer m Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats. Joint diseases and related surgery. 2020; 31(2): 260 - 266. 10.5606/ehc.2020.72592
IEEE KORUCU İ,Kekeç A,ARSLAN A,oltulu p,özer m "Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats." Joint diseases and related surgery, 31, ss.260 - 266, 2020. 10.5606/ehc.2020.72592
ISNAD KORUCU, İsmail Hakkı vd. "Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats". Joint diseases and related surgery 31/2 (2020), 260-266. https://doi.org/10.5606/ehc.2020.72592